BOA Defined Travelling Fellowship 2017

Application Form A

Please complete and return this application form accompanied by a letter of support from your Training Programme Director and a copy of your full CV by 31th October2016. Applicants may only use either application form A or B, not both.For more information, please visit the BOA website, or email .

All applications for the BOA Travelling Fellowships are considered by the BOA’s Education and Revalidation Committee. Applicants must be current BOAHome Associates, and awards will not be made to supplement funded or salaried fellowship posts; the BOA Travelling Fellowship should be the primary funding source.

This application form has been designed for those BOA Home Associates who wish to apply for a DefinedBOA Travelling Fellowship (as listed below), but will also be considered for a General Travelling Fellowship if unsuccessful. Please note that these fellowships are subject to funding. These include:

Soli Lam Spinal Fellowshipx 1 @£10,000

Zimmer Fellowships – Adult Reconstructive in Hips and Kneesx 4 @ €3,000

Zimmer Fellowship – Adult Reconstructive Extremities x 1 @ €3,000

Zimmer Fellowship – Traumax 1 @ €3,000

Zimmer/Passage to India Fellowshipsx 2 @ €1,500

Andrew Sprowson Fellowship – Management of infectionx 1 @ £1,500

EFORT Travelling Fellowshipx 1*

*For this fellowship please ensure you have read the aims and rules of the EFORT Travelling Fellowship – financial support from the BOA will cover travel to and from the European country hosting the fellowship.

SURNAME: [Prof/Mr/Dr/Mrs/Miss/Ms]

FIRST NAMES:

DATE OF BIRTH:

Home details
HOME ADDRESS: / Hospital Details
HOSPITAL ADDRESS:
TELEPHONE NUMBER:
(inc. dialling code) / TELEPHONE NUMBER:
(inc. dialling code)
MOBILE NUMBER:
EMAIL ADDRESS: / POSITION HELD:

Preferred Fellowship(please identify a preference for up to three fellowships, in rank order – 1 = most preferable):

Soli Lam Spinal Fellowship
Zimmer Fellowships – Adult Reconstructive in Hips and Knees
Zimmer Fellowship – Adult Reconstructive Extremities
Zimmer Fellowship – Trauma
Zimmer/ Passage to India Fellowships
EFORT Travelling Fellowship

Short description of your prospective placement/ Fellowship (up to 100 words):

Proposed date of travel (do not complete for the EFORT Travelling Fellowship):

Estimated costs of travel and accommodation (these should relate to the costs of the individual undertaking the fellowship only, and should correlate to the chosen fellowship(s) stated above):

Cost incurred / Amount

*For those applying for the EFORT Travelling Fellowship, please note that onlytravel costs toand from the European country hosting the fellowship.

Details of other funding received or applied for:

Will you continue to receive your salary on top of any fellowship funding?

For the EFORT Travelling Fellowship only:

What is it about the Fellowship that appeals to you, why are you applying, and what do you hope to achieve?

(Please provide a maximum of 2 pages. This section will expand as you type).

For all other BOA Travelling Fellowships:

Please provide details of your proposed placement/ Fellowship. Describe what you hope to achieve from the placement, including any particular skills you would like to acquire and give details of any research projects you would like to undertake (please provide a maximum of one side of an A4 page).

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The closing date for application is 31th October, 2016. Shortlisting for interview will be based upon the application form, CV and TPD letter of support. Please send your CV and TPD letter of support as separate PDF attachments with your application.

The selection of BOA Travelling Fellows will be based upon the communication of the following criteria at the January interview (in the form of a presentation to BOA Education Committee members):

  • Fellowship plan
  • How well organised/developed
  • Suitability for career
  • Eligibility criteria

Shortlisted candidates will be required to attend a skype interview on Sunday 8th January 2016.

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